Analysis of Prognostic Factors in Renal Cell Carcinoma

Chang, Yong Seuk; Moon, Woo Chul; Kim, Young Sun

Abstract

The clinical course of individual patient with renal cell carcinoma (RCC) is variable and difficult to predict accurately. The values of various classical prognostic factors in RCC remain ill-defined. Data on molecular analysis of oncogene and tumor suppressor genes including p53 may provide useful prognostic information for RCC. We herein investigated the prognostic value of multiple clinical and pathological parameters as well as p53 mutation in 40 patients with pathologically confirmed RCC. Mutations of p53 gene were analyzed by immunohistochemical staining using monoclonal antibody for p53 protein( M1801). On univariate analysis using log-rank test multiple parameters showed prognostic value, including clinical stage ( Robson), nuclear grade, mutation of p53, cell type, body weight loss, anemia, and increased serum level of calcium and erythrocyte sedimentation rate. However, on multivariate analysis using Cox's proportional hazard model only three parameters including stage(p <0.001 ), nuclear grade(p < 0.05), and mutation of p53(p<0.05) were found to have significant independent prognostic value. These results suggest that in RCC clinical stage and nuclear grade are two most important prognostic factors and analysis of p53 mutation may provide additional important prognostic information.